Provider Demographics
NPI:1841385655
Name:GARTENLAUB, SETH (DC)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:GARTENLAUB
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BOND ST
Mailing Address - Street 2:STE 201
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2418
Mailing Address - Country:US
Mailing Address - Phone:516-466-4900
Mailing Address - Fax:516-466-4901
Practice Address - Street 1:8 BOND ST
Practice Address - Street 2:STE 201
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2418
Practice Address - Country:US
Practice Address - Phone:516-466-4900
Practice Address - Fax:516-466-4901
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009022111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02276277Medicaid
NY5898516OtherGHI
NYP1244581OtherOXFORD
NY7680231OtherATENA
NY9170353OtherPHCS
NY1029940OtherASN
NYC09022-7BOtherWORKERS COMPENSATION BOAR
NYP-11195476OtherMULTIPLAN
NYX8H65OtherEMPIRE BC/BS
NY2018345OtherUNITED HEALTHCARE
NYP-11195476OtherMULTIPLAN
NY7680231OtherATENA
NY02276277Medicaid
NYU74407Medicare UPIN
NYA400013816Medicare PIN